Causes of the ozena
Ozena (atrophic rhinitis) is characterized by an offensive odor, atrophy of the nasal mucosa, and nasal crusting. Ozena (atrophic rhinitis) is more common in girls during puberty, usually disappears in adulthood.
Despite numerous theories, the etiology of ozena disease remains unclear to this day. Genetic factors and environmental conditions are considered the main causes of ozena. Sometimes Ozena (atrophic rhinitis) starts at about 8 years of age. Morphological changes in the ozena are characterized by the fact that the glands of the mucous membrane atrophy, the epithelium becomes keratinized and rejected. With the ozena, not only the nasal mucosa atrophies but also the bony skeleton of the turbinates.
When ozena, crusts of a grayish-green color are formed, which decompose, which is accompanied by a fetid putrid odor from the nose (the children themselves may not feel it due to atrophy of the olfactory analyzer receptors). Despite the excessively wide nasal cavity, due to sharp atrophy in the lake, breathing through the nose is sometimes difficult. Dryness in the nose and throat, impaired or complete absence of smell, atrophic pharyngitis, laryngotracheobronchitis is constant symptoms accompanying the ozena.
Корки при озене нередко образуют слепок полости носа, удаляются с трудом, слизистая оболочка под ними резко атрофична, бархатисто-красного цвета, местами кровоточит, иногда виден скелет носовых раковин. Носовые раковины при озене атрофичны, небольшие по размеру. В задних отделах полости носа и носоглотке при озене наблюдаются аналогичные изменения, но выраженные в меньшей степени. Задняя стенка глотки при озене так же раздражена, характеризуется наличием корок, сухим блеском (как бы покрыта лаком).
Exceptional perseverance of the doctor, the use of complex measures, including local and general treatment, are required. Local treatment includes rejection and removal of crusts, irrigation with alkaline solutions (1% soda solution, glycerin can be added), lubrication or instillation of Lugol's solution into the nasal cavity, inserting a tampon with bee chalk, sterile vaseline, peach, apricot oil for 1-2 hours, alkaline inhalation. Daily lubrication of the mucous membrane with iodine-glycerin is useful.
Nasal washings (0.6% sodium chloride solution at room temperature) are done with a nasal watering can; you should not use a syringe, since even a weak pressure promotes the penetration of water into the holes of the auditory tubes. Under the influence of slowly flowing fluid, the soft palate contracts and separates the nasopharynx from the oral cavity, as a result of which water flows out of the other half of the nose. The head should be slightly tilted forward; during washing, the patient breathes through the mouth, trying not to swallow water. At the end of the rinsing, he should blow his nose from each half of the nose separately. Dry crusts are first softened, then washed out.
For the general effect, autohemotherapy, blood transfusion, protein and vaccine therapy are carried out, nicotinic acid, vitamin A is administered, injections of aloe extract, cocarboxylase are made.
In adults, under the guise of an ozena, a chronic purulent process of the sinuses, mainly of the ethmoid labyrinth and the sphenoid bone, is often hidden. In such cases, it is difficult to establish the source of suppuration. It turned out that the so-called reflex neuroses associated with changes in the nose (headache, neuralgia, asthma, cough, epileptoid seizures, etc.) do not play the same role as previously attributed to them. The modern point of view is this: if there are pathological changes in the nose, possibly associated with neurosis, they should be eliminated, but it is possible that after the end of local treatment, "nervous suffering" will remain. Surgery is decided if changes in the nose significantly interfere with breathing. Elimination of the anatomical causes of breathing difficulties has the greatest chances of success because reflex disorders after the operation at least decrease.
Doctors differ on the impact of nasal treatment on menstrual disorders. There are cases when cocaine treatment, by burning the corresponding points in the nose (the anterior end of the inferior concha) temporarily or for a long time relieves pain or cramps during menstruation, so even if there is no certainty of success, such treatment can still be tried.